A glimpse in post-COVID pathophysiology: the role of exhaled breath condensate pH as an early marker of residual alveolar inflammation

Portacci, Andrea; Pierucci, Paola; Quaranta, Vitaliano Nicola; Quaranta, Sara; Iorillo, Ilaria; Locorotondo, Cristian; Buonamico, Enrico; Dragonieri, Silvano; Carpagnano, Giovanna Elisiana

doi:10.1080/17476348.2022.2130764

Cited by 2 publications

(2 citation statements)

References 38 publications

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“…In addition, alveolar and bronchial air fraction was not separated in EBC sampling. We believe however that measuring the total fraction EBC is also valuable, since studies have demonstrated both airway and alveolar long-COVID inflammatory sequels [[38], [39]].…”

Section: Discussionmentioning

confidence: 99%

Exhaled Breath Condensate and Respiratory Sequelae in Children Post-COVID-19

Fireman Klein,

Yaacoby-Bianu,

Orlin

et al. 2023

Respiration

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an acute respiratory illness. A substantial proportion of adults experience persistent symptoms. There is a paucity of data on respiratory sequelae in children. Exhaled breath condensate (EBC) is a non-invasive tool used to assess airway inflammation. Objectives: This study aimed to evaluate EBC parameters, respiratory, mental and physical ability among children post COVID-19 infection. Methods: Observational study of confirmed SARS-CoV-2 infection cases among children, aged 5–18 years, evaluated once, 1–6 months post positive SARS-CoV-2 PCR testing. All subjects performed spirometry, 6-min walk test (6MWT), EBC (pH, interleukin-6), and completed medical history questionnaires, Depression, Anxiety, and Stress Scale (DASS-21), and physical activity scores. Severity of COVID-19 disease was classified according to WHO criteria. Results: Fifty-eight children were included and classified asymptomatic (n = 14), mild (n = 37), and moderate (n = 7) disease. The asymptomatic group included younger patients compared to the mild and moderate groups (8.9 ± 2.5y vs. 12.3 ± 3.6y and 14.6 ± 2.5y, respectively, p = 0.001), as well as lower DASS-21 total scores (3.4 ± 4 vs. 8.7 ± 9.4 and 8.7 ± 0.6 respectively, p = 0.056), with higher scores in proximity to positive PCR (p = 0.011). No differences were found between the 3 groups regarding EBC, 6MWT, spirometry, body mass index percentile, and activity scores. Conclusions: COVID-19 is an asymptomatic-mild disease in most young healthy children, with gradually diminishing emotional symptoms. Children without prolonged respiratory symptoms revealed no significant pulmonary sequelae as evaluated by EBC markers, spirometry, 6MWT, and activity scores. Larger studies are required to assess long-term pediatric consequences of post SARS‐CoV‐2 infection, to assess the need for pulmonology surveillance.

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Section: Discussionmentioning

confidence: 99%

Exhaled Breath Condensate and Respiratory Sequelae in Children Post-COVID-19

Fireman Klein,

Yaacoby-Bianu,

Orlin

et al. 2023

Respiration

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“…PCED is a debilitating condition requiring targeted management, including frequent follow-up consultations and otherthan-respiratory specialist evaluation (4,12,28,29). A proper ongoing outpatient service is then needed in the appropriate healthcare setting, in the framework of a holistic multi-disciplinary approach, including pulmonary functional investigations, respiratory rehabilitation facilities (1,15), and invasive and non-invasive imaging examinations (30)(31)(32)(33)(34)(35). Such dedicated service would mitigate the post-COVID disease trajectory, thus potentially preventing the worsening of daily life and/or professional impairment, as well as avoiding future hospitalizations (15,34).…”

Section: Discussionmentioning

confidence: 99%

Significant burden of post-COVID exertional dyspnoea in a South-Italy region: knowledge of risk factors might prevent further critical overload on the healthcare system

Resta,

Cuscianna,

Pierucci

et al. 2023

Front. Public Health

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BackgroundExertional dyspnoea in post-COVID syndrome is a debilitating manifestation, requiring appropriate comprehensive management. However, limited-resources healthcare systems might be unable to expand their healthcare-providing capacity and are expected to be overwhelmed by increasing healthcare demand. Furthermore, since post-COVID exertional dyspnoea is regarded to represent an umbrella term, encompassing several clinical conditions, stratification of patients with post-COVID exertional dyspnoea, depending on risk factors and underlying aetiologies might provide useful for healthcare optimization and potentially help relieve healthcare service from overload. Hence, we aimed to investigate the frequency, functional characterization, and predictors of post-COVID exertional dyspnoea in a large cohort of post-COVID patients in Apulia, Italy, at 3-month post-acute SARS-CoV-2 infection.MethodsA cohort of laboratory-confirmed 318 patients, both domiciliary or hospitalized, was evaluated in a post-COVID Unit outpatient setting. Post-COVID exertional dyspnoea and other post-COVID syndrome manifestations were collected by medical history. Functional characterization of post-COVID exertional dyspnoea was performed through a 6-min walking test (6-mwt). The association of post-COVID exertional dyspnoea with possible risk factors was investigated through univariate and multivariate logistic regression analysis.ResultsAt medical evaluation, post-COVID exertional dyspnoea was reported by as many as 190/318 patients (59.7%), showing relatively high prevalence also in domiciliary-course patients. However, functional characterization disclosed a 6-mwt-based desaturation walking drop in only 24.1% of instrumental post-COVID exertional dyspnoea patients. Multivariate analysis identified five independent predictors significantly contributing to PCED, namely post-COVID-fatigue, pre-existing respiratory co-morbidities, non-asthmatic allergy history, age, and acute-phase-dyspnoea. Sex-restricted multivariate analysis identified a differential risk pattern for males (pre-existing respiratory co-morbidities, age, acute-phase-dyspnoea) and females (post-COVID-fatigue and acute-phase-dyspnoea).ConclusionOur findings revealed that post-COVID exertional dyspnoea is characterized by relevant clinical burden, with potential further strain on healthcare systems, already weakened by pandemic waves. Sex-based subgroup analysis reveals sex-specific dyspnoea-underlying risk profiles and pathogenic mechanisms. Knowledge of sex-specific risk-determining factors might help optimize personalized care management and healthcare resources.

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A glimpse in post-COVID pathophysiology: the role of exhaled breath condensate pH as an early marker of residual alveolar inflammation

Cited by 2 publications

References 38 publications

Exhaled Breath Condensate and Respiratory Sequelae in Children Post-COVID-19

Exhaled Breath Condensate and Respiratory Sequelae in Children Post-COVID-19

Significant burden of post-COVID exertional dyspnoea in a South-Italy region: knowledge of risk factors might prevent further critical overload on the healthcare system

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